It is often difficult to find research on a group of children that exactly fits the profile or diagnosis of a child that you are working with; there are many reasons why a child might be documented as having special educational needs and disabilities (SEND). It is therefore often helpful to focus on specific difficulties, and the aim of this article is to provide some insight into research that cuts across many of the conditions or difficulties a child with special educational needs might present with: literacy; language and communication; social, emotional and mental health difficulties (SEMH), in particular anxiety; and sensory processing difficulties.

Literacy

Difficulties in the development of reading, spelling or comprehension are some of the most common reasons for students to be referred to their school SENCo. A child who is not making expected progress in these areas may be referred for further assessment, and comparing attainment in these areas against a child’s general ability is important. Research in these areas has seen a recent focus on intervention and, more encouragingly, evaluation of intervention. Understanding the root of difficulties in literacy is complex, drawing on genetic, brain-based and neuropsychological research. However, it is not too controversial to suggest that literacy difficulties are characterised by difficulties with phonemic processing and/or comprehension.

The most common varieties of intervention are those focusing on phonemic awareness (targeting awareness of the individual phonemes that compose words, for example, ‘cat’ as /k/ /a/ /t/), phonological awareness (targeting sounds at the level of the word ‘mat’, ‘cat’, ‘sat’) and reading fluency (for example, repeated reading with error feedback to increase speed and fluency). Phonemic awareness is likely to be more immediately relevant to reading development, because many (regular) words require decoding at the level of the phoneme. Interventions focusing on reading fluency, meanwhile, are suggested to work because more automatic reading frees up the child’s working memory to allow better comprehension. Comprehension interventions that function without a phonics focus work on strategies to decipher text and derive meaning, such as summarising, use of prior knowledge and inferential thinking (Suggate, 2016).

Previous research indicates that various reading intervention programmes can be effective in improving children’s reading skills in the short term, but how far these improvements reach have been explored less often (Ehri et al., 2011). Suggate (Suggate, 2016) reports on a meta-analysis to look specifically at the long-term outcomes of these intervention programmes, and reports that those interventions that involved a phonemic awareness component, or those that focused on comprehension development (particularly for older students), showed the most positive long-term improvement. The report also provided recommendations for different age groups. For preschool and Reception class, interventions should target phonemic awareness, developing decoding skills in Years 1 and 2. In the first years of formal schooling, fluency and mixed interventions appear to be particularly efficacious. From the junior years onwards, reading comprehension interventions would appear, on average, optimal. However, while these findings are useful as a guide, Suggate notes that these recommendations do not discount the importance of personalising interventions to individual needs (a caveat that is relevant to each section of this article).

Language, communication and social relationships

Language and communication issues are common across a broad spectrum of special educational needs and at all levels of schooling; speech delay in preschool, developmental language disorder, and difficulties with the social-pragmatic uses of language will all have an important effect on a child’s ability to engage with their peer group (Mok et al., 2014), but also sometimes in their ability to access the curriculum. In one longitudinal study following children from four to 12 years old, difficulties with language were also reported to predict later behavioural problems (Petersen et al., 2013). Often, speech, language and communication needs will require the input of a specialist speech and language therapist, but understanding that many of the difficulties seen in a classroom may be underpinned by language (and, particularly, social-pragmatic language) difficulties is also important for teaching professionals.

In the SCIP (Social Communication Intervention Project) programme, based around an intervention for pragmatic language difficulties (Baxendale et al., 2012), classroom behaviour and independent working appeared to be a priority for teachers; as a result, activities that addressed relevant skills, such as listening, comprehension monitoring (the child recognising and signalling that they have not understood), vocabulary and narrative work were all areas that were important to develop. Teaching assistants were also supported to work with children on emotion, language and regulation.

In the programme, communication between speech and language therapists and teachers was found to be vital so that therapy work can be continued in class, and teacher observations of in-class difficulties can be worked on during treatment sessions; teachers reported that being able to have short meetings with the therapist involved with their student meant that they gained a greater understanding of the child’s individual difficulties and about what strategies might be effective. Here, as with many areas of practice, it is clear that investment in liaison and cooperative planning between teachers, parents and specialists is an important part of the intervention itself and is also relevant to outcomes for the child. The next article in this journal (Lofthouse et al., 2018) reports on an approach to enhancing teachers’ knowledge from speech and language science through specialist coaching from speech and language therapists, providing a specific example of this in context.

Social, emotional and mental health (SEMH) and anxiety

In 2015, the Office for National Statistics published work indicating that one in eight children aged 10 to 15 reported symptoms of mental ill-health. There is a large range of behaviours that are relevant to children with SEMH, including school refusal, aggression and anxiety about school. Many students with SEMH have experienced significant difficulties or trauma in their home lives, and teachers working with such children need to be mindful of how best to work with students who are often highly (or overly) attuned to threat in their environment.

Students who have experienced abuse or other traumas may be more likely than others to respond aggressively to situations that they perceive as threatening, although of course there may be many other causes of aggression, too; Thornton (Thornton, 2017) provides a useful review of aggressive behaviour in school-age children. These children may also be likely to have greater difficulties with classroom-necessary skills such as planning, cognitive flexibility and shifting attention (MacDonald et al., 2015).

Understanding how to manage students with heightened anxiety is a useful skill for teachers. Anxiety may exist not only as a result of life experiences, but also in response to specific classroom situations, including mathematics, writing and foreign language learning. Studies on maths anxiety indicate that anxiety may hinder achievement through its effect on working memory, and this may also be the case for students who experience more generalised difficulties with anxiety. A recent meta-analysis was clear in demonstrating that self-reported or experimentally-induced anxiety was detrimental to working memory capacity, as well as resulting in poorer performance across a wide variety of tasks (Moran, 2016).

Sensory processing

Issues with processing sensory information are common to many developmental conditions, including autism, developmental coordination disorder, ADHD, cerebral palsy and foetal alcohol spectrum conditions. However, sensory sensitivities are also observed in children who have no diagnosable condition; 16% of children in one study were reported by their parents to have sensitivities to sounds or tactile sensations, and these profiles were associated with higher frequencies of behavioural and mental health difficulties, and poorer social-emotional regulation skills (Ben-Sasson et al., 2009). There is little research on how sensory processing issues affect children in the classroom in general, but much more is known about working with sensory sensitivities in children with autism, and much of this is relevant and adaptable to most children who present with sensitivity to sensory experiences.

Sensory processing difficulties can take the form of hypersensitivity (where noises are too loud or lights too bright) or hyposensitivity (characterised by constant movement, ‘thrill-seeking’ behaviour or scratching or biting oneself). In a classroom setting this may manifest as an inability to filter out certain kinds of noises or moving around and/or fidgeting on the carpet or in a chair. Both types of sensory processing difficulties are associated with academic underachievement. It can be difficult (or indeed impossible) to adjust a classroom to meet every child’s needs, but there are things that teachers can do to help a child who finds processing sensory information more difficult than their peers. There has been little rigorous research, but small-scale studies and individual case studies indicate the success of the use of noise-cancelling headphones to reduce the effect of extraneous noise (Ikuta et al., 2016), or an allowance to eat lunch away from a noisy dinner hall.

Conclusion

Being mindful of difficulties relating to speech and language, sensory processing and social, emotional and mental health difficulties can often provide a way in to working with a child who is under-achieving or otherwise not managing in the classroom. When working with students with SEND, as with many areas of practice, investment in liaison and cooperative planning between teachers, parents and specialists is important.

 

References

Baxendale J, Lockton E, Adams C, et al. (2012) Parent and teacher perceptions of participation and outcomes in an intensive communication intervention for children with pragmatic language impairment. International Journal of Language & Communication Disorders (48): 41–53.
Ben-Sasson A, Carter A and Briggs-Gowan M (2009) Sensory over-responsivity in elementary school: Prevalence and social-emotional correlates. Journal of Abnormal Child Psychology (37): 705–716.
Ehri L, Nunes S, Stahl S, et al. (2011) Systematic phonics instruction helps students learn to read: Evidence from the National Reading Panel’s meta-analysis. Review of Educational Research (71): 393–447.
Ikuta N, Iwanaga R, Tokunaga A, et al. (2016) Effectiveness of earmuffs and noise-cancelling headphones for coping with hyper-reactivity to auditory stimuli in children with autism spectrum disorder: A preliminary study. Hong Kong Journal of Occupational Therapy (28): 24–32.
Lofthouse R, Flanagan J and Wigley B (2018) Talking it through: Using specialist coaching to enhance teachers’ knowledge from speech and language sciences. Impact (2): 85–88.
MacDonald H, Ellis B, Pulsifer M, et al. (2015) Executive Functioning in Children with Posttraumatic Stress Disorder Symptoms. Journal of Child and Adolescent Trauma (8): 1–11.
Mok P, Pickles A, Durkin K, et al. (2014) Longitudinal trajectories of peer relations in children with specific language impairment. Journal of Child Psychology and Psychiatry 55: 516–527.
Moran T (2016) Anxiety and working memory capacity: A meta-analysis and narrative review. Psychological Bulletin (142): 831–864.
Petersen I, Bates J, D’onofrio B, et al. (2013) Language ability predicts the development of behavior problems in children. Journal of Abnormal Psychology (122): 542.
Suggate S (2016) A meta-analysis of the long-term effects of phonemic awareness, phonics, fluency, and reading comprehension interventions. Journal of Learning Disabilities (49): 77–96.
Thornton S (2017) Addressing aggressive behaviour in school-aged children. British Journal of School Nursing (12): 302–304.